1. No category

Moderator’s name
and address:
Date
Dear Headteacher/Principal
Moderation of Coursework
REQUEST FOR SAMPLE
Centre No.
Specification Code/Unit
Code
Component
Code
Specification Title and Unit Title
Thank you for sending the mark sheets and other documents relating to your candidates’ coursework in the
specification shown above.
Will you kindly arrange to send me, within three days of receipt of this letter, the complete coursework of the
candidates listed overleaf. A copy of this letter must be returned to me with the sample of work.
Please note that, in addition to the sample of work requested overleaf, you should also send the work of any
candidate for whom an Application for Special Arrangements for Coursework has been approved, together
with a copy of the letter of authorisation.
Please ensure that a Centre Authentication Form (CCS160) is sent to me with the coursework sample. This
form should be signed by the person(s) responsible for the internal administration of coursework. Copies of
Candidate Centre Authentication Statements are not required.
Yours sincerely
Coursework Moderator
CW/L1 – EM000025 Revised October 2009
Oxford Cambridge and RSA Examinations
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MODERATION OF COURSEWORK
SAMPLE REQUIRED
Centre Number
Specification /Unit Code
Component Code
#
Candidate Number
Candidate Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CW/L1 – EM000025 Revised October 2009
Oxford Cambridge and RSA Examinations
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STATEMENT OF DESPATCH
OF COURSEWORK SAMPLES
The top copy of this form should be sent to OCR immediately after you have completed the return of
Coursework samples to Centres
Specification/Unit Code
Specification/Unit
Title
Component Code
Component Title
Moderator’s Name
Exceptions
Centre Number
(List all Centres from which work was
received)
Example:
2
2
9
9
9
Air Waybill
Number
Sample
Size
4050063021
15
Date of Return
to the Centre
25
09
05
Candidates
Sent to
(List candidate numbers or
write ‘whole sample’
if appropriate)
(Name the Team Leader or
Principal Moderator to whom
the work was sent)
2050, 2051
P/M, T/L Mr Hall
I certify that I have no Coursework in my possession. All samples have been returned to the Centres from which
they were received with the exception of those items identified above.
Signed
Date
CW/MOD/DESP – EM000047 (2 Part NCR) Top – Qualification Team / Bottom – Retained by Moderator Revised Sept 2007
Oxford Cambridge and RSA Examinations
Assessor Contents return